SAFANSI

A group watches videos that raise awareness about nutrition and hygiene in the Rangamati district of the Chittagong Hill Tracts, Bangladesh. Photo Credit: ASHIKA Development Associates

It was very early in the morning when the call came. Minoti Chakma was in labor, and her husband knew something was not right.

She had been in pain for a while. The midwife and the family elderlies were trying to help her deliver the baby, a common practice in that remote indigenous community in the Chittagong Hill Tracts (CHT) of Bangladesh.

A malnourished child will face poorer outcomes as an adult. In South Asia, where malnutrition persists in multiple forms, improving nutrition in the early stages of life is critical to a child's future development and health. Credit: World Bank

But whether an individual consumes—or not—nutritious food is contingent upon a myriad of factors, ranging from the availability of certain foods, how convenient they can be turned into meals, or simply, if they meet consumers’ tastes.

Across South Asia, four known species of indigenous, fully mature, small food-fish – now dubbed ‘NutriFish’ have nutritional and health benefits for pregnant and lactating women and young children when consumed over the first one thousand days. Here, children from Kothi, Odisha in India show their curiosity and share their excitement with a new kind of harvest happening in their village. Credit: Arun Padiyar
Kale, Kefir, and Quinoa have now joined the ranks of better-known foods like Blueberries, Orange Sweet Potato, and Salmon on family dinner tables across the world.

Considered superior for their health and nutrition benefits, these so-called ‘Superfoods’, often considered “new” by the public are now ever-popularized by celebrity chefs and have become all the rage of foodies from San Francisco to Singapore.

We live in a world of paradox, where old world and almost forgotten food like Quinoa (which dates back as a staple food over three thousand years to Andean civilization but largely disappeared with the arrival of the Spanish) is now back on the menu.

Salmon, a staple part of Nordic diets from paleolithic times and woven into the culture of native populations across northwestern Canada and many other superfoods share comparable stories.

And, there are many other old world foods, indigenously known, disappearing but not fully forgotten, yet to be re-discovered.

And parents, from both rich and poor nations alike, seem to know something is not quite right.

If healthier food choices that are accessible, affordable, and readily available are better known, would parents purchase such food from the market for their families?

With a small grant from the World Bank-administered South Asia Food and Nutrition Initiative (SAFANSI) supported by the EU and the United Kingdom, a partnership with WorldFish was established to test this premise.

A 60 second TV spot, a collaboration between scientists, economists, a private sector digital media company, broadcasters and the Government of Bangladesh, was created and broadcast across the nation on two occasions and watched by over 25 million people.

A parallel radio program was also developed and aired reaching millions more, particularly the rural poor and marginalized communities.

These deficiencies have contributed to high levels of stunting, wasting and underweight children.
Global micronutrient deficiency (as a percentage of the population). Two billion people in the world lack key micronutrients such as Vitamin A or iron. South Asia has the most critical malnutrition levels. Source: UNICEF

In 2016, the Food Safety and Standards Authority of India released standards for the fortification of five staple food items: rice, wheat, salt, oil, and milk. Further to that, regulations are now in place to fortify milk variants such as low fat, skimmed, and whole milk with Vitamin A and D.

But despite its significant health benefits, and while established for more than three decades by companies such as Mother Dairy, a subsidiary of the National Dairy Development Board (NDDB), milk fortification is not yet common practice across the Indian milk industry.

Over the last twelve months, this collaboration has enabled ten milk federations, dairy producer companies, and milk unions across the country to pilot milk fortification for their consumers. Fifteen others have initiated the process.

Last year, Afghanistan became the 60th country to join Scaling Up Nutrition (SUN), a global movement to end malnutrition, and thus signaled its strong commitment to invest in a better future for its citizens.

On the other hand, a well-nourished child tends to complete more years of schooling, learns better, and earns higher wages in adulthood, thereby increasing the odds that he or she will escape a life of poverty.[1]

School children singing and dancing in Samtse Dzongkhag. Photo Credit: Izabela Leao / World Bank

Bhutan is no ordinary place.

A landlocked Himalayan kingdom tucked in a mostly rugged mountainous terrain between India and China, it measures prosperity by assessing its citizens’ level of happiness by way of a Gross National Happiness index.

Bhutan’s geography – with land rises ranging from 200 meters in the southern foothills to 7,000 meters in the high northern mountains – consists of three major agro-ecological zones that allow for a rich biodiversity and seasonal foods.

"Many families in rural Bhutan practice two meals rather than three meals a day," reports Ms. Kinley Bidha, Tarayana Foundation Field Officer in Samtse Dzongkhag. "Some for cultural reasons, others due to a shortage of food, others due to a shortage of land too farm," she adds.

Nonetheless, the lack of variety of foods in diet remains a key concern, especially for pregnant and nursing women as well as young children. And while most families feed their children complementary food, fewer than a quarter of parents provide them nutritious meals essential to their health.

In addition, 67 percent of Bhutanese adults consume less than the recommended five servings (or 400 grams) of fruits and/or vegetables per person a day [National Nutrition Survey (NNS) 2015].

When consumed, vegetables consist for the most part of two national staples, potatoes and chilies, which hardly provide essential vitamins and minerals.

Keeping regional variations in mind, between 16 and 34 percent of children under 5 are stunted—or too short for their age—seven percent of children are underweight, 35 percent of children of age 6-59 months and 44 percent of women of reproductive age are either anemic or iron deficient. Exclusive breastfeeding rates for six-month-old children remain at a low 50 percent (NNS, 2015).

Silvi and her mother arrive with Silvi’s birth certificate to enroll into Jawtno. a cash transfer program that aims to help 600,000 poor families in Bangladesh access prenatal and child care. Credit: World Bank

Silvi is eight months old. She lives in a remote village in one of the poorest regions of Bangladesh.

Her mother Maya often reflects on her pregnancy and worries about her daughter’s wellbeing as she recalls her morning sickness, the uncertain and painful birth, and the long nights at Silvi’s side as the baby lay wide awake wailing, fighting one illness after the other.

She remembers, too, the thrills of hearing Silvi giggle at the sound of her rattle, and when she began to crawl.

Despite the little joys that her baby brings to Maya, Silvi’s early childhood was marked with apprehension: Shouldn’t she be a little heavier? When will she learn to walk? Will she be healthy and intelligent enough to earn a decent living when she grows up? Or would she be handed down her parents’ poverty and get married like Maya had to, at only sixteen?

But with the right kind of support, Silvi can have a chance at a better life and bring her family out of poverty.